Preliminary results of a multicenter randomized study on the treatment of acute promyelocytic leukemias
- 作者: Parovichnikova EN1, Savchenko VG1, Demidova IA1, Isaev VG1, Shuravina EN1, Ustinova EN1, Gribanova EO1, Alexanyan MZ.1, Misyurin AV1, Domracheva EV1, Olshanskaya Y.V1, Khoroshko ND1, Kravchenko SK1, Konstantinova TS1, Anchukova LV1, Kaplanov K1, Zagoskina TP1, Volkova SA1, Filatov LВ1, Rekhtman GВ1, Sokolova I1, Mashuk VN1, Milyulina GI1, Lapin VA1, Perekatova TN1, Sviridova EI1, Pristupa AS1, Zyuzgin IS1
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- 期: 卷 79, 编号 7 (2004)
- 页面: 11-18
- 栏目: Editorial
- ##submission.dateSubmitted##: 09.04.2020
- ##submission.datePublished##: 15.07.2004
- URL: https://ter-arkhiv.ru/0040-3660/article/view/29988
- ID: 29988
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Material and methods. The trial was made with participation of 18 hematological departments of clinics in Russia. A total of 68 APL patients entered the trial. The maintenance therapy consisted of 5day courses of cytostatic drugs which alternated or did not altenate with 5-day courses of ATRA. Cytogenetic tests were made in 31 patients, t(15;17) was detected in 26 of them. Molecular examination conducted in 28 patients discovered chimeric transcript PML/RARa in 26 of them. Of 20 patients examined in Hematological Research Center, 7 (35%) had a bcr 1/2 variant of the transcript PML/RARa, 13 (657c) - bcr 3 variant.
Results. 65 patients were eligible for assessment. A complete remission was achieved in 90% cases. No resistance was observed. In follow-up within 30 months the recurrence rate was similar on both treatments. The results of the induction therapy and survival in patients with different variants of the transcripts were also simitar. Overall 2.5 year survival for all the patients was 77%, recurrence-free 80%. The survival analysis in patients with leukocytosis higher and lower 10 lO9/! found no statistical differences by the survival. Patients with hyperleukocytosis had higher early lethality than patients with leukocytes under 10 Iff/I (25% vs 5.3%, p = 0.03).
Conclusion. The APL 06.01 protocol showed high efficacy of the relevant maintenance which provides a complete molecular remission in the majority of patients with probable recurrence-free 2.5 year survival 80%.
作者简介
E Parovichnikova
V Savchenko
I Demidova
V Isaev
E Shuravina
E Ustinova
E Gribanova
M Alexanyan
A Misyurin
E Domracheva
Yu Olshanskaya
N Khoroshko
S Kravchenko
T Konstantinova
L Anchukova
K Kaplanov
T Zagoskina
S Volkova
L Filatov
G Rekhtman
I Sokolova
V Mashuk
G Milyulina
V Lapin
T Perekatova
E Sviridova
A Pristupa
I Zyuzgin
参考
- Avvisali G., Petti М. С., Lo Coco F. et al. AIDA: the Italian way of treating acute prom myelocytic leukemia (APL), final act. Blood 2003; 102 (11): abstr. 487.
- Bourgeois E., Chevret S., Sanz M. et al. Long term follow up of APL treated with ATRA and chemotherapy (CT) including incidence of late relapses and overall toxicity. Blood 2003; 102 (II): abstr. 483.
- Hand H., Bradstock K., Chong L. et al. Results of the APML3 trial of ATRA, intensive idarubicin, and triple maintenance combined with molecular monitoring in acute promyelocytic leukaemia (APL): a study by the Australasian Leukaemia and Lymphoma Group (ALLG). Blood 2003; 102 (11): abstr. 484.
- Lengfelder E., Saussele S., Haferlach T. et al. Treatment of newly diagnosed acute promyelocytic leukemia: the impact of high dose ara-C. Blood 2003; 102 (11): abstr. 488.
- Sanz M. A., Martin G., Barragan E. et al. Risk-adapted treatment of acute promyelocytic leukemia: results of the Spanish PETHEMA trials using ATRA and anthracycline-based chemotherapy. Blood 2001; 98 (11): abstr. 3187.
- Lengefelder E., Saussele S., Haferlach T. et al. Low relapse rate after intensified induction therapy including high-dose ARA- С and all-transretinoic acid in patients with acute promyelocytic leukemia. Blood 2001; 98 (11): abstr. 3188.
- Schienk R. F., Profiling S., del Valle F. et al. High-dose cytarabine in consolidation therapy for acute promyelocytic leukemia (APL). Blood 2000; 96 (11): abstr. 3126.
- Fenaux P., Chastang C., Chevret S. et al. A randomized comparison of all-transtetinoic acid (ATRA) followed be chemotherapy and ATRA plus chemotherapy and the role of maintenance therapy in newly diagnosed acute promyelocytic leukemia. Blood 1999; 94 (4): 1192-1200.
- Fenaux P., Chevret S., Sanz M. et al. ATRA followed by chemotherapy (CT) vs ATRA plus CT, and the role of maintenance therapy in newly diagnosed acute promyelocytic leukemia (APL): long term follow-up of APL 93 trial. Blood 2001; 98 (11, suppl. 1): abstr. 3190.
- Савченко В. Г., Паровичникова Е. Н. Лечение острых лейкозов. М.: МЕДпресс-информ; 2004. 62-110.
- Jurcic J. G., Nimer D., Scheinberg D. A. et al. Prognostic significance of minimal residual disease detection and PML- RARa isoform-type: long-term follow-up in promyelocytic leukemia. Blood 2001; 98 (9): 2651-2656.
- Burnett A. K., Grimwade D., Solomon E. et al. Presenting white blood cell count and kinetics of molecular remission predict prognosis in acute promyelocytic leukemia treated with alltransretinoic acid: results of randomized MRC trial. Blood 1999; 93 (12): 4131-4143.
- Douer D., Santillana S., Ramezati L. et al. Acute promyelocytic leukemia in patients originating in Latin America is associated with an increased frequency of the bcrl subtype of the PML/ RARa fusion gene. Br. J. Haematol. 2003; 122: 563-570.
- Sanz M. A., Martin G., Rayon С. et al. High antileukemia afficacy and reduced toxicity of a modified AIDA protocol ommitting non-intercalating agents from consolidation in acute promyelocytic leukemia. Updated resuls of the PETHEMA LPASS protocol. In: Programme and abstract book of joint international congress on APL and differentiation therapy. 2000. 58, abstr. P7.16.
- Crimwade D. The significance of minimal residual disease in patients with t(15; 17). Best Pract. Res. Clin. Haematol. 2002; 15 (1): 137-158.
- Diverio D., Pandoli P., Rossi P. et al. Monitoring of treatment outcome in acute promyelocytic leukemia by RT-PCR. Leukemia 1994; 8: 1105-1112.
- Do Coco F., Diverio D., Avvisati G. et al. Therapy of molecular relapse in acute promyelocytic leukemia. Blood 1999; 94: 2225-2229.
- Crimwade D., Jamal R., Goulden N. et al. Salvage of patients with acute promyelocytic leukaemia with residual disease following ABMT performed in second CR using all-trans retinoic acid. Br. J. Haematol. 1998; 103 (2): 559-562.
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